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Gastric Emptying Scintigraphy

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Gastroparesis

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Since the scintigraphic measurement of gastric emptying uses readily available and now more standardized meals and permits accurate quantification of gastric emptying, it has remained the gold standard for measuring gastric emptying. This chapter reviews the normal physiology of gastric emptying of solids and liquids. It summarizes the most recent consensus recommendations on how to perform gastric emptying studies including: patient preparation, use of a standardized low-fat, egg-white meal, image acquisition, analysis, and results reporting. The value of liquid gastric emptying studies and newer methods to measure fundal accommodation and antral contractions are also reviewed.

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References

  1. Parkman HP, Hasler W, Fisher R. American Gastroenterological Association medical position statement: diagnosis and treatment of gastroparesis. Gastroenterology. 2004;127:1589–91.

    Article  PubMed  Google Scholar 

  2. Lin H, Prather C, Fisher R, et al. Measurement of gastrointestinal transit (AMS Task Force Committee on Gastrointestinal Transit). Dig Dis Sci. 2005;50(6):989–1004.

    Article  PubMed  Google Scholar 

  3. Thumshirn M. Pathophysiology of functional dyspepsia. Gut. 2002;51 Suppl 1:i63–66.

    Article  PubMed  Google Scholar 

  4. Bonapace ES, Maurer AH, Davidoff S, Krevsky B, Fisher RS, Parkman HP. Whole gut transit scintigraphy in the clinical evaluation of patients with upper and lower gastrointestinal symptoms. Am J Gastroenterol. 2000;95(10):2838–47.

    Article  PubMed  CAS  Google Scholar 

  5. Feldman M, Smith HJ. Effect of cisapride on gastric emptying of indigestible solids in patients with gastroparesis diabeticorum. Gastroenterology. 1987;92:171–4.

    PubMed  CAS  Google Scholar 

  6. Donohoe K, Maurer A, Ziessman H, Urbain J, Royal H, Marin-Comin J. Procedure guideline for adult solid-meal gastric emptying study 3.0. J Nucl Med Technol. 2009;37:196–200.

    Article  PubMed  Google Scholar 

  7. Datz F, Christian P, Moore J. Gender-related differences in gastric emptying. J Nucl Med. 1987;28:1204–7.

    PubMed  CAS  Google Scholar 

  8. Gill R, Murphy P, Hooper H, Bowes K, Kingma Y. Effect of the menstrual cycle on gastric emptying. Digestion. 1987;36:168–74.

    Article  PubMed  CAS  Google Scholar 

  9. Knight LC, Parkman HP, Brown KL, et al. Delayed gastric emptying and decreased antral contractility in normal premenopausal women compared with men. Am J Gastroenterol. 1997;92(6):968–75.

    PubMed  CAS  Google Scholar 

  10. Tougas G, Eaker EY, Abell TL, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol. 2000;95(6):1456–62.

    Article  PubMed  CAS  Google Scholar 

  11. Guo JP, Maurer AH, Fisher RS, Parkman HP. Extending gastric emptying scintigraphy from two to four hours detects more patients with gastroparesis. Dig Dis Sci. 2001;46(1):24–9.

    Article  PubMed  CAS  Google Scholar 

  12. Moore JG, Datz FL, Greenberg CE, Alazraki N. Effect of body posture on radionuclide measurements of gastric emptying. Dig Dis Sci. 1988;33(12):1592–5.

    Article  PubMed  CAS  Google Scholar 

  13. Maurer AH, Knight LC, Vitti RA, Siegel JA, Krevsky B, Charkes ND. Geometric mean vs. left anterior oblique attenuation correction: affect on half emptying time, lag phase, and rate of gastric emptying. J Nucl Med 1991;32.

    Google Scholar 

  14. Couturier O, Bodet-Milin C, Querellou S, Carlier T, Turzo A, Bizais Y. Gastric scintigraphy with a liquid-solid radiolabelled meal: performances of solid and liquid parameters. Nucl Med Commun. 2004;25(11):1143–50.

    Article  PubMed  Google Scholar 

  15. Ziessman H, Ankit C, Clarke J, Ramos A, Wahl R. The added value of liquid gastric emptying compared with solid emptying alone. J Nucl Med. 2009;50:726–31.

    Article  PubMed  Google Scholar 

  16. Cremonini F, Delgado-Aros S, Talley NJ. Functional dyspepsia: drugs for new (and old) therapeutic targets. Baillieres Best Pract Res Clin Gastroenterol. 2004;18(4):717–33.

    Article  CAS  Google Scholar 

  17. Camilleri M, Malagelada JR, Brown ML, Becker G, Zinsmeister AR. Relation between antral motility and gastric emptying of solids and liquids in humans. Am J Physiol. 1985;245:G580–5.

    Google Scholar 

  18. Collins PJ, Horowitz M, Chatterton BE. Proximal, distal and total stomach emptying of a digestible solid meal in normal subjects. Br J Radiol. 1988;61:12–8.

    Article  PubMed  CAS  Google Scholar 

  19. Urbain JL, Siegel JA, Charkes ND, Maurer AH, Malmud LS, Fisher RS. The two-component stomach: effects of meal particle size on fundal and antral emptying. Eur J Nucl Med. 1989;15:254–9.

    Article  PubMed  CAS  Google Scholar 

  20. Siegel JA, Urbain JL, Adler LP, et al. Biphasic nature of gastric emptying. Gut. 1988;29:85–9.

    Article  PubMed  CAS  Google Scholar 

  21. Ziessman H, Bonta D, Goetze S, Ravich W. Experience with a simpliefied, standardized 4-hour gastric-emptying protocol. J Nucl Med. 2007;48:568–72.

    Article  PubMed  Google Scholar 

  22. Delgado-Aros S, Camilleri M, Cremonini F, Ferber I, Stephens D, Burton D. Contributions of gastric volumes and gastric emptying to meal size and postmeal symptoms in functional dyspepsia. Gastroenterology. 2004;127(6):1685–94.

    Article  PubMed  Google Scholar 

  23. Sarnelli G, Caenepeel P, Geypens B, Janssens J. Symptoms associated with imparied gastric emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol. 2003;98(4):783–8.

    Article  PubMed  Google Scholar 

  24. Scott A, Kellow J, Shuter B, et al. Intragastric distribution and gastric emptying of solids and liquids in functional dyspepsia. Dig Dis Sci. 1993;38:2247–54.

    Article  PubMed  CAS  Google Scholar 

  25. Gonlachanvit S, Aronchick R, Kantor S, Maurer A, Fisher R, Parkman H. Regional gastric emptying abnormalities in nonulcer dyspepsia and gastroesophageal reflux disease. Am J Gastroenterol. 2000;95:2452–3.

    Article  Google Scholar 

  26. Piessevaux H, Tack J, Walrand S, Pauwels S, Geubel A. Intragastric distribution of a standardized meal in health and functional dyspepsia: correlation with specific symptoms. Neurogastroenterol Motil. 2003;15(5):447–55.

    Article  PubMed  CAS  Google Scholar 

  27. Urbain JL, Vekemans MC, Bouillon R, et al. Characterization of gastric antral motility disturbances in diabetes using the scintigraphic technique. J Nucl Med. 1993;34:576–81.

    PubMed  CAS  Google Scholar 

  28. Soykan I, Sivri B, Sarosiek I, Kierran B, McCallum R. Demography, clinical characteristics, psychological profiles, treatment and long-term follow-up of patients with gastroparesis. Dig Dis Sci. 1998;43:2398–404.

    Article  PubMed  CAS  Google Scholar 

  29. Knight LC, Parkman HP, Miller MA, et al. Delayed gastric emptying in normal women is associated with decreased antral contrctility. Am J Gastroenterol. 1997;92:968–75.

    PubMed  CAS  Google Scholar 

  30. Gregersen H, Frieling T. Function and dyspepsia: a start of a new friendship. Neurogastroenterol Motil. 2004;16:271–3.

    Article  PubMed  Google Scholar 

  31. Bouras E, Delgado-Aros S, Camilleri M, et al. SPECT imaging of the stomach: comparison with barostat and effects of sex, age, body mass indes, and fundoplication. Gut. 2002;51:781–6.

    Article  PubMed  CAS  Google Scholar 

  32. Kuiken S, Samson M, Camilleri M, et al. Development of a test to measure gastric accommodation in humans. Am J Physiol. 1999;277:G1217–21.

    PubMed  CAS  Google Scholar 

  33. Simonian H, Maurer A, Knight L, et al. Simultaneous assessment of gastric accommodation and emptying: studies with liquid and solid meals. J Nucl Med. 2004;45:1155–60.

    PubMed  Google Scholar 

  34. Heyman S. Gastric emptying in children. J Nucl Med. 1998;39:865–9.

    PubMed  CAS  Google Scholar 

  35. Thomas EJ, Kumar R, Dasan JB, Bal C, Kabra SK, Malhotra A. Prevalence of silent gastroesophageal reflux in association with recurrent lower respiratory tract infections. Clin Nucl Med. 2003;28(6):476–9.

    PubMed  Google Scholar 

  36. Reyhan M, Yapar AF, Aydin M, Sukan A. Gastroesophageal scintigraphy in children: a comparison of posterior and anterior imaging. Ann Nucl Med. 2005;19(1):17–21.

    Article  PubMed  Google Scholar 

  37. Caglar M, Volkan B, Alpar R. Reliability of radionuclide gastroesophageal reflux studies using visual and time-activity curve analysis: inter-observer and intra-observer variation and description of minimum detectable reflux. Nucl Med Commun. 2003;24(4):421–8.

    Article  PubMed  CAS  Google Scholar 

  38. Thomas EJ, Kumar R, Dasan JB, et al. Gastroesophageal reflux in asthmatic children not responding to asthma medication: a scintigraphic study in 126 patients with correlation between scintigraphic and clinical findings of reflux. Clin Imaging. 2003;27(5):333–6.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiology, Temple University Hospital, Philadelphia, PA, 19140, USA

    Alan H. Maurer MD (Professor of Radiology and Internal Medicine)

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  1. Alan H. Maurer MD
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Correspondence to Alan H. Maurer MD .

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Editors and Affiliations

  1. School of Medicine, Department of Medicine, Temple University, N. Broad St. 3401, Philadelphia, 19140, Pennsylvania, USA

    Henry P. Parkman

  2. Paul L Foster School of Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Ce, Alberta Avenue 4800, El Paso, 77905, Texas, USA

    Richard W. McCallum

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Maurer, A.H. (2012). Gastric Emptying Scintigraphy. In: Parkman, H., McCallum, R. (eds) Gastroparesis. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-552-1_9

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  • DOI: https://doi.org/10.1007/978-1-60761-552-1_9

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-551-4

  • Online ISBN: 978-1-60761-552-1

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